Vitamin D Doesn't Improve Cardiac Measures in CKD Patients

No improvements in left ventricular mass, measures of diastolic dysfunction with paricalcitol therapy

WEDNESDAY, Feb. 15 (HealthDay News) -- Patients with chronic kidney disease who are treated with the active vitamin D compound, paricalcitol, for 48 weeks do not show improvement in left ventricular mass or certain measures of diastolic dysfunction, compared with patients who received placebo, according to a study published in the Feb. 15 issue of the Journal of the American Medical Association.

Ravi Thadhani, M.D., M.P.H., from the Massachusetts General Hospital in Boston, and colleagues conducted a multinational, double-blind, randomized placebo controlled trial with 227 patients with chronic kidney disease, mild to moderate left ventricular hypertrophy, and preserved left ventricular ejection fraction. Participants were assigned to receive either oral paricalcitol, 2 µg/d (115 patients), or placebo (112 patients). The change in left ventricular mass index was measured over 48 weeks by cardiovascular magnetic resonance imaging.

The researchers found that paricalcitol was associated with a decline in parathyroid hormone levels within four weeks, which was maintained within the normal range throughout the study duration. At 48 weeks, there was no difference between the treatment groups for the change in left ventricular mass index. There was also no difference between the groups for Doppler measures of diastolic function, including peak early diastolic lateral mitral annular tissue velocity. Compared with the placebo group, the paricalcitol group had more frequent episodes of hypercalcemia.

"Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in patients with chronic kidney disease," the authors write.